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The Science and Culture of Medical Wear Design Virginia Commonwealth University VCU Scholars Compass Theses and Dissertations Graduate School 2014 Dr. WHO?: The Science and Culture of Medical Wear Design Patricia Duignan Virginia Commonwealth University Follow this and additional works at: https://scholarscompass.vcu.edu/etd Part of the Fashion Design Commons, Fiber, Textile, and Weaving Arts Commons, Health Information Technology Commons, Nanotechnology Commons, Occupational Health and Industrial Hygiene Commons, Other Public Health Commons, and the Social and Behavioral Sciences Commons © The Author Downloaded from https://scholarscompass.vcu.edu/etd/3991 This Thesis is brought to you for free and open access by the Graduate School at VCU Scholars Compass. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of VCU Scholars Compass. For more information, please contact [email protected]. DR. WHO? The Science and Culture of Medical Wear Design Patricia Duignan Dr. WHO?: The Science and Culture of Medical Wear Design A thesis submitted in partial fulfillment of the requirements for the degree of Master of Fine Arts at Virginia Commonwealth University by Patricia Duignan B.DES in Fashion Design, National College of Art & Design, Dublin, Ireland, May 1994. Thomas Modeen Acting Director, MFA Design Studies MFA Thesis 16 June 2015 Peter S Chomowicz Thomas Modeen Primary Advisor Acting Director of Graduate Studies Associate Dean for Research and Development Virginia Commonwealth University in Qatar Virginia Commonwealth University in Qatar Paolo Cardini Allyson Vanstone Secondary Advisor Dean Associate Professor Virginia Commonwealth University in Qatar Rhode Island School of Design (RISD) Jesse G Ulmer Dr. F. Douglas Boudinot Reader Dean, School of Graduate Studies Assistant Professor, Liberal Arts and Science Virginia Commonwealth University Virginia Commonwealth University in Qatar CONTENTS ACKNOWLEDGEMENTS 2 ABSTRACT 4 INTRODUCTION 6 Background 7 DESIGN PROCESS 10 The Lab Coat and Symbolic Representation 11 Development of Historical Symbolism 13 Psychological Dynamics of the Lab Coat 17 Summary 18 INVESTIGATION I 20 PRODUCT PRECEDENTS ANALYSIS 28 Investigation I 29 Investigation III 30 Investigation IV 33 Investigation V 36 Analysis 42 HOSPITAL SYSTEM 44 Healthcare Associated Infections (HAIs) 45 DESIGN PROCESS 46 Enclothed Cognition 48 Design 50 Future Scenario I 51 Future Scenario II 53 Design Innovation 59 EXHIBITION 61 CONCLUSION 65 END NOTES 67 TABLE OF FIGURES 70 BIBLIOGRAPHY 72 I ACRONYMS AND ABBREVIATIONS 74 II DEFINITION OF TERMS 74 Thank you to all the wonderful people who helped me along this path. …my husband Matthew for his continued love and support and most of all taking up the slack with the kids. …my gorgeous children Arabella and Oisin for their humor, laughter and putting up with an absent mummy. …my friend Sandy Wilkins for endless support and words of wisdom. …my friend Byrad Yelland for his guidance, helping shape my thesis into a proper academic piece of work. …my colleague Catherine Chiuco for wonderful collaboration and beautiful design of my thesis book. …my friend Rob Valenta and his team at Quantum Media for collaborating and producing my slick video. …my helpers Narita Mattock, Abdul Cader for guidance and reminding me of fashion skills I had not used in a long while. …my colleague, fellow student and friend Hadeer Omar for assisting in video creation, constant advice and guidance along the way. …my models, Margarita, Sheika, Maryam, Rabab, Samia who graciously volunteered and gave up their time to model in my video …my advisors Paolo Cardini, Jesse Ulmer for their belief, support and advise. …my primary advisor Peter Chomowicz for the continued support and pushing me to think in ways I otherwise would not have. ABSTRACT The multi-million-dollar medical uniform industry has not utilized medical, functional, cultural and symbolic roles of the lab coat within advancements in garment and textile technology that could positively the hospital environment and beyond, to the larger the global society. impact the protection of healthcare professionals and patients. In This thesis examines the extent to which the design of medical wear most cases the uniforms meet basic requirements – they clothe can impact the effect of hospital-acquired infections, support doctor/ the professional in a recognizable way. Little innovation in design, patient relationships and enhance the performance and behavior of function and performance, has been applied to these garments. This the healthcare professional by envisioning a future lab coat which THE MEDICAL is particularly evident in the case of the stereotypical white lab coat which offers increased protection for physician and patient, aids in worn by many physicians, despite evidence indicating that these lab communication and enhances the performance of the doctor by utilizing coats may carry contamination and play a role in the spread of deadly digital technologies incorporated into the lab coat whereby the lab coat bacteria. Healthcare Associated Infections (HAIs) are among the becomes the only tool necessary for the physician. UNIFORM most serious problems facing modern medical care, costing millions of lives and dollars annually worldwide. This research investigates the design and use of the physician’s lab coat – an immediately recognizable symbol of Western medicine. The research identifies the 04 INTRODUCTION As principal investigator of a large-scale project to design the clinical working with the same materials and textile makers who produce cloth wear uniforms for the new Sidra Medical and Research Center in consistently year after year. Having served both as an in-house fashion Qatar, I discovered that the field of medical uniforms is characterized designer at a garment manufacturer and as a client, I am aware of the by a lack of innovation almost unheard of in the fashion industry. commercial limitations placed on designers. In the commercial world Much of the literature on medical uniforms focuses on the policies, garment cost is the bottom line, and if a design threatens profits it is symbolism of uniforms and is undertaken by standards authorities and typically either disregarded or is stripped of its expensive components the medical profession.1 In contrast the research carried out by uniform to achieve the price target. Price targets are dictated by previous selling manufacturers is lacking; and what design-based research there is, has prices and competitor prices. All of these factors combine to create typically been developed with only minimal input from the people who a heavily standardized market of commercial designs. The aim of will wear the end product.2 Within the design industry, professional this research is to creatively investigate design options for a medical garments such as medical uniforms are designed to accommodate uniform, in this case the physician’s lab coat, and develop a conceptual the existing manufacturing capabilities of the producer, which can prototype that will break free of the bonds of market standardization to limit a critical design approach and innovation.3 One consequence of present a garment that is designed to assist physicians in carrying out PREFACE this is the lack of focus on garment performance, resulting in a classic all aspects of their role. Data for this research was collected through a fashion approach offering seasonal product updates that have minimal triangulation of personal observation, interview and document review aesthetic variations, typically changes only in color and simple with informants medical professionals, administrators, textile engineers styling details. Manufacturers tend to stick to tried and tested fabrics, and garment manufacturers. 06 BACKGROUND The physician’s lab coat and clothing has been the subject of much followed by 23% stating the need to carry medical instruments, and debate. The “bare below the elbow policy” (BBE) was introduced 15% stated to keep their clothes underneath clean. However, when by the UK’s Department of Health in 2007 to tackle nosocomial assessing the results, it is important to note that only 29% of the study infection, and banned the wearing of wristwatches, neckties, and population actually wore the white lab coat (82% of the doctors were long sleeves for clinicians. However, the same research found that working in pediatrics and psychiatry). Reasons for not wearing the coat physician’s neckties are worn repeatedly and rarely cleaned; making included avoiding a negative impact on patients. Interestingly, research them the perfect substrate to carry bacteria from patient to patient as suggests that even with the decline of popularity in wearing the white physicians go about their rounds. Watches, moreover, are susceptible coat among physicians, it is still desired by many patients. In another to contamination for the same reasons. In addition, long sleeves study, 56% of patients favored doctors wearing white lab coats.8 Similar were deemed a hindrance to the vital exercise of hand washing. results were obtained during a study of 168 patients from three teaching However, C. A. Willis-Owen, et al carried out research in 2009 family medicine clinics in Israel, in which 52% of the patients preferred to examine the effect of the policy on the presence of bacteria on a physician in a white lab coat because it signaled a trustworthy doctors’ hands and concluded that there was no significant difference profession.8 It is evident that there are inconsistent theories for or against between the presence of bacteria on the hands of the doctors who the use of the lab coat, it is clear that there are personal and professional were compliant with the policy and those who were not.4 However, preferences which influence the decision making however if a lab coat is other research has found that what doctors’ wear has an important worn, it should function in ways that support both the doctor and patient, psychological effect on patients. Subramanian, et al, demonstrated offering protection, comfort, and reassurance to both parties. that patients perceive the BBE-compliant uniforms as unhygienic; thus, the patients’ confidence in the doctor may be undermined.
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